
Your Coverage
Drug Plan:
80% coverage to a maximum of $2000.00 per policy year for
- Most prescriptions drugs or medicines
- Insulin injectibles
- Insulin supplies including syringes, needles and diagnostic strips, including glucometers, alcohol swabs and lancets, subject to a maximum of $500.00 per insured per policy year.
- Allergy serums
- Oral contraceptives

Exclusion: - ALL acne preparations, including ACCUTANE
- Preventative vaccines , including hepatitis B
- Contraceptives, other than ORAL
- Anti smoking remedies
- Fertility drugs
- Over the counter products or medicines available without a prescription
Health Plan Reminders: If you have any questions call 1-800-315-1108
You can view your plan booklet and download claim forms online.
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